Plné znění - 241/2006 Sb.

Xxxxxxxxxxxxx xxx xxx Assessment xx Applications xxx xxx Xxxxxxxxx xx Xxxxxxxxx Xxxxxxx to Xxxxxxx xx Xxxxxxxx Xxxx pursuant xx Xxx No. 209/1997 Xxxx., xx xxx xxxxxxxxx xx fulancial xxxxxxx to xxx xxxxxxx xx xxxxxxxx xxxx xxx xx xxxxxxxx xxxxxxx other xxxx, xx xxxxxxx

Xxxx Xxx/Xxxxx,

Xx xxxxxxxxx xxx xxxxxxxxx xxx xxxx xxxxxxxx questions xx xxxx xxxxxxx situation. Xxxxxxx, filling xx xxxx xxxxxxxxxxxxx xx xxxxxxxx for the xxxxx xxxxxxxxxx xx xxxx xxxxxxxxxxx for xxx xxxxxxxxx of xxxxxxxxx xxxxxxx pursuant xx Xxx xx. 209/1997. Xxxxx xxx xxx xxxx xxxxxxxxxxx; xx xx xxxxxx xxxxxxxxxxx.

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X. Xxxxxx legibly xxxx xx xxx xxxxxxxx xxxx of xxx xxxxxxxxx - x.x. xxx xxxxxx xx xxx xxxxxxxx xxx xxx xxx xxxxxxxx bodily xxxx, xx the xxxxxxxx xx a xxxxxx xxx has xxxx xx xxxxxxxxxxx of xxx criminal xxx:

1. Xxxxxxx:

2. Given name:

3. Xxxx xx xxxxx:

4. Xxxxxxxxx xxxxxxx:

5. Mail xxxxxxxx address (should xx diffen from xxx xxxxxxxxx address, xxxx):

6. Xxxxx Xxxxxx:

7. X-xxxx xxxxxxx:

8. Xxxxxxxxxxx:

XX. Xx the applicant xx xxxxxxxxxxx xx xxxxxxx xxxxxx ("xxxxxxxxxxxxxx") xx the xxxxx xx xxxxxxxxx xxxxxxxxxxxxxx (xxx xxxxxxxx, a xxxxx child xxxxxxxxxxx xx xxx/xxx xxxxxx) xx xx xxx xxxxx xx x xxxxx xx xxxxxxxx, xxxxxx fill in xxx xxxx xx xxxx xxxxxxxxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxxxxxxx xx xxxxxxxxxx address:

If xxx xxxxxxxxxxxxxx xx xxxxxx the xxxxxxxxxxx xx behalf xx xxx xxxxxxxxx, xxxxxx xxxx xxxxxx x xxxxxxxx xxxxxxxxxxx xxx/xxx xx represent xxx xxxxxxxxx - x xxxx xx a xxxxx of xxxxxxxx (xxx xxxxxxxxxxx xxxxxxxxxxxxxx) xx a xxxx xx the xxxxx xxxxxxxxxxx (xxx statutory xxxxxxxxxxxxxx) xx xxx xxxxx xxxxxxxxxx document.

III. Xx xxx xxxxxxxxx xx a xxxxxxxx xx x person xxx xxx died xx xxxxxxxxxxx of xxx respective xxxxxxxx xxx, xxxxxx xxxx xx xxx personal xxxx of xxx xxxxxxxx:

1. Xxxxxxx:

2. Xxxxx xxxx:

3. Xxxx of xxxxx:

4. Xxxx of xxxxx:

5. Xxxx xxxxxxxxx xxxxxxx:

6. Xxxxxxxxxxx:

7. Relationship xx xxx xxxxxxxx xx xxx xxxxxxxxx (x.x. xxxxxx, xxxxxxxx, xx xxxxxxxxxx living xx common xxxxxxxxx)

Xx xxx xxxxxxxxx xx x xxxxxxxx xx x xxxxxx who xxxx xx xxxxxxxxxxx xx the xxxxxxxx xxx, please xxxxxx x copy xx xxx xxxxx certificate xxx xxx documents xxxxxxx xxxx the xxxxxxxx xxxxxxxxx or xxx xx xxxxxxxxxx xx xxxxxxx xxx xxxxxxxx (in the xxxx of a xxxxxx-xxxxx xxxxxxxxxxxx, xxxx xxxxxxxxx xxxxxxx xxxxx xxxxxxxxxxxx or a xxxxx xxxxxxxx xx xxx xxxxxxxxxx to xxxxxxx xxx dependent; xx the case xx xxxxxxx couples, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxxx).

Xxxxxx xxxxxxx xxx xxxx xx xxxxx xxx crime was xxxxxxxxx xxx, xx xxx victim xxxxxxx xxxxx xxx consequences xx the xxxxx xx x later xxxx, please also xxxxxxx xxx xxxx xxx the xxxxxx xx xxxxx xxx xxxxxx xxxxxxx of xxxx consequences (e.g., xxx xxxx of xxx medical xxxxxx).

XX. Xxxxxx xxxxxxx the xxxxxxxx xxxxxxx xxxxxxxxx (x.x. xxxxxx, xxxxxx xxxxxxxxxx'x office, xxxxx) xxxxx xxxx xxxxxxxx xxxxxxxxx criminal proceedings. Xxxxx xxx xxxxxxxxx xxxxxx xx the xxxx xxxxxxx xx xxx xxxxxxxxxx xxxxxxxxxxx.

Xx xxxxxxxxx, please xxxxxx xxx xxxxxx decision xx xxx xxxxxxxxxxxxxx xxxxxxxx justice xxxxxxxxx xxxxx xxxxx xxxxxxxx xxx stage xx xxx xxxxxxxxxx xxxxxxxxxxx (x.x. xxxxxxxxxx xx xxx xxxxxxxxxxxxxxx of xxxxxxxx xxxxxxxxxxx, xxxx xx xxx xxxxxxxxxx, xxxxxxxxx - xxxxx xx xxxxxxxxx).

According xx xxx provisions xx §8 of Xxx xx. 209/1997, xxx amount xx xxxxxxxxx support xxx xx xxxxxxx xx xxxxxxxx xxxxxxxxx xx xxxxxxx the xxxxxx xxx made use xx xxx xxxxx xxxxxxxx xx xxxxxxx x xxxxx xxx xxxxxxxxxxxx against the xxxxxxxx xx xxx xxxxx xxxxxx xxxxxxxxxxx xxx xxx xxxx xxxxxxxx. Do xxx xxxx xx xxxx xxxx xx xxx xxxxxxxx has xxx xxxx identified.

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Fill xx xxxx XxXx xx xxx xxxxxxxxx is x survivor xx xx xxxxxxxxxx xxx xxx xxxx in xxxxxxxxxxx xx the xxxxxxxxx xxxxx.

1. Xxx xxx a xxxxx, xxxxxx or xxxxx xx xxx xxxxxx who xxxx xx consequence xx xxx xxxxxxxx xxxxxxx?

2. Xxx you live xx a common xxxxxxxxx xxxx xxx xxxxxxxx xxxxxx xxxxx xx xxx commitment xx xxx xxxxx?

3. Xxxx xxx x xxxxxxxxx xx xxx xxxxxx xx xxx xxx deceased obliged xx xxxxxxx xxx?

4. Xx any xxxxx xxxxxxx xxxx xxx xxxxxxxxxx described in xxxxxxx 1 xx 3? Xxxxxx xxxx xxxxx xxxxxx, xx xxxxx to you.

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According xx xxx xxxxxxxxxx xx §2, xxxxxxx 2 xx Xxx xx. 209/1997, a xxxxxx xxx xx x survivor xx x victim who xxxx in consequence xx a xxxxxxxx xxx is xxxxxxxxxx xx xx x xxxxxx xx he xx she xx x xxxxxx, spouse xx xxxxx of xxx xxxxxxxx and xxxxx xxxx xxx xx xxx xx xxx same xxxxxxxxx xx xx xxx xxxxxx xxx x xxxxxxxxx xx xxx xxxxxxxx or xxx xxxxxxxx xxx required xx xxxxxxx xxx xxxxxx.

Xx xxx xxxxxxxxx xx xxx victim xx x crime xxx xxx suffered xxxxxx xxxx, xxxxxx xxxx xx xxxxx XX - XXX.

Xxxxxx attach x xxxxx-xxxxx xxxxxxxxxx xx xxxx and xxxxxxxxx pursuant xx Xxxxxx No. 440/2001 Xxxx. Xxx xxxxxxxxxx xxxxxxxx xxxxxx xx xxxxxxxx from xxx xxxxxxxxx responsible for xxx xxxxxx'x treatment. Xxxx xxxxxxx xxxxxx xxxx xxxxxxx x xxxxx-xxxxx assessment xx xxx xxx xxxxxxxx xxx a xxxxx-xxxxx xxxxxxxxxx of xxx xxxxxxxx xx xxx xxxxxx'x xxxxxx xxxxxxxx. Xxxxxx xxxx xx xxxx xxxx xxxx xxx xxxxx-xxxxx assessment xx xxx pam xxxxxxxx is xxxxxxxx xxx the xxxxxxxx xx Xxx no. 209/1997. Xxxxxxxxx to xxx xxxxxxxxxx xx §6, xxxxxxx 2 xx Xxx xx. 209/1997, xx financial xxxxxxx will xx xxxxxxxx xxxxxx xxx xxxxx xxxxxxxxxx xx xxx xxxx xxxxxxxx xx xx least 100 xxxxxx.

The xxxxxx xxx xxxxxx xxxx xxx xxxxxxxxx xxxxxxx xx xxx xxxxxx xx CZK 25,000 xx xx xxxxxx xxxxx xx xxx xxxxxx xxxxx xx xxxxxxx treatment xxx xxxx xxxxxx (§7, xxxxxxx 1, xxxxxx x xx Xxx Xx. 209/1997 Xxxx.). lf you xxxxxx xx xxxxx xxx x xxxx xxx xxxxxxx, xxxxx xx xx xxxx xx fill xx xxxxx XII - XxX.

Xxxx xxxxxxxx xxx xxxxxxxx xxx xxxxxxxxxx, xxxxxxxx xxxxxxxxx, xxxxxxxxxxxxxx xxxxx, xxxxxx xx xxxxxxxxx to xxxx out in xxx xxxx or xxxx xxxxxxx xxxxxxxxx, xxxxxxxxx xxxxxxxxxxxxxx xxxxx xxx., xxxxxxxx xxxx xxxxx xxxx not xxxx xxxx xx xx xxxxxxxxx xxxxxxx. xx xxxx expenses xxx xxx proved xx xxxxxxxxxxx evidence, xxx Xxxxxxxx xx Xxxxxxx xxx xxx xxxx xxxx into xxxxxxxxxxxxx.

Xxxxxx xxxxxx xxx xxxxxxxxx xxxxxxxxxx xxxx xxxxx xx xxx xxxxxxxxxxx.

Xx xxx xxxxxxxxx xx an xxxxxxxx, xxxxx xxxxxxxxx xxxxx xxxxxxx x xxxxxxxxx from xxx/xxx xxxxxxxx xxxxxxxxxx xxx xxxxxxx xxxxxx according xx §351 xx. xxx. xx Xxx xx. 262/2006, the Xxxxx Xxxxxx Xxxx, xx xxxxxxx. xx xxx xxxxxxxxx xx xxxx-xxxxxxxx, xxxx document xxxxx be x xxxx of xxx/xxx xxxx recent xxx xxxxxx. lf the xxxxxxxxx xx a xxxxxxx person xxx xx able xx xxxxx xxx/xxx xxxxxxxx xxxxxx xxxxxxxx, xxxxxx xxxxxx x xxxxxxxx xxxxxxxxxx the xxxxxx xx xxx xxxxxxxxxx xxxxxxx. xx for xxx xxxxxx the xxxxxxxxx'x xxxxxx xxxxxxxxx xxxxxx xx proven, xx exceptional xxxxx xx xxxxxxxxx may xx xxxxxxxx.

My xxxxxx standing xxx xxxx xxxxxxxx xx x xxxxxx xx xxx xxxxxxxx xxx xx xxxxx I xxx a victim. X xxxx xxx xxx xxxx compensated xxx xxx xxxx 1 have suffered xx x xxxxxx xx xxx criminal xxx.

X xxxxxx affirm xxxx I have xxx xxxxxx xxx xxxxx xxx xxxxxxxxx xxxxxxx xx xxx xxxxxxx xxxxx for xxxxxxxxxxxx xxx xxx xxxx xxxxxxxx xx x xxxxxx xx xxx xxxxxxxx xxx xx any xxxxxxx xxxxx than xxx Xxxxx Xxxxxxxx.

X acknowledge xxxx xxxxxxxxx to §12 xx Act Xx. 209/1997 Coll., xx the xxxxxxxxx xx xxxxxxxxx xxxxxxx xxx the xxxxxxx xx xxxxxxxx acts xxx xx xxxxxxxx xxxxxxx xxxxx xxxx, xx xxxxxxx, X xx xxxxxxx xx xxxxxxxxx xxx Ministry xx Xxxxxxx xxx xxxxxx xxxxxxxx as xxxxxxxxxxxx for xxx xxxx suffered, up xx xxx xxxxxx xx xxx xxxxxxxxx xxxxxxx, xxxxxx xxxx xxxxx from xxx xxxx xx receiving xxx xxxxxxx xxxxxxx. X xxxx xxxxxxxxxxx xxxx, after xxx xxxxx xx xxx xxxx-xxxx xxxxxx, X xxx xxxx xx xxxxxxxxxxx xxxxxx xxx Xxxxxxxx of Xxxxxxx xx xxxxx the xxxxx'x xxxxx for xxx xxxxxx xx xxx xxxxxxxx xxxxxxx, xxxxxx xxxx x xxxxxx xx well xxxxxxxx by my xxxxxx standing, xxx xxxxx xxxxxx xx xxxx suffered xxx xxx amount of xxxxxxxxxxxx xxxxxxxx.

X xxxx xxxxxxxxxxx that consciously xxxxxx xxxxx xx xxxxxxxxxx information xx xxxxxxxxxxx xxxxxxxxxxx xxx xxx xxxxxxxx xx xxxxxxxxxxxxx xxxxxxx xxxxxxxx xxx xxxxxxxxx an xxxxxxx pursuant xx §21, xxxxxxx 1, xxxxxx x) xx Xxx xx. 200/1990 Xxxx., xx xxxxxxxx xx xxxxxxx.

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Xxxxxxxxx xx xxx applicant or xxx/xxx xxxxxxxxxxxxxx

- Upon xxxxxxx xx xxx xxxxxxxxxxx for xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx xxxxxxxx xx Xxx Xx. 209/1997, xxx Ministry xx Xxxxxxx shall confirm xxxxxxx xxx xxxxxx xx a xxxxxx xxxxxx. Subsequently, xxx Xxxxxxxx xxxxx initiate xx xxxxxxxxxxxxx xxxx xxx police xx x xxxxxxx authority xx per xxx xxxxxxxx xxxxxxx of xxx case. Within xxxxx xxxxxx from xxx xxxx xx xxx xxxxxxx xx xxx xxxxxxxxxxx xxx xxxxxxxxxx xx xxx xxxxxxxxx xxxxxxxxx, xxx Xxxxxxxx xxxxx either xxxxxxx xxx xxxxxxx xx inform xxx xxxxxxxxx of the xxxxxxx why xxxx xxxxxxx has been xxxxxxxx.

- The xxxxxxxxx xxxxx xx xxxxxxxxxx x xxxxxx xx xxx Xxx No. 209/1997 Coll. xxxx xx xx/xxx xxx xxxxxxxx xxxxxx harm xx a xxxxxx xx xxx xxxxxxxxxx xx a xxxxx. X xxxxxxxxx xxx xxx xxx xxxx xxxxxxxxx xxx xxx xxxxxx'x xxxxxxx xx xxxxxxxx xxxxxxx xxxxx xx xxx xxxxxx xx the point-based xxxxxxxxxx xx the xxx suffercd (not xxx xxxxxxxxx of xxxxxx xxxxxxxx), xxxxx xxxx xx xx xxxxx 100 xxxxxx. Xxxxxxxxx xx x xxxxxx who has xxxx xx xxxxxxxxxxx xx a xxxxx xxxxx be xxxxxxxxxx xx be x xxxxxx xx xxx xxxxxxxx xx x xxxxxx, xxxxxx xx xxxxx of xxx xxxxxxxx xxx xxx xxxxxxxx xxxxxx a xxxxxxxxx xxxx xxx xxxxxxxx xx the xxxx xx his/her xxxxx xx xx xxx deceased xxxxxxxxx xx xxx xxxxxxxx xx xxxxxxx xxx xxxxxxxx.

- Act Xx. 209/1997 Xxxx. xx xxx xxxxxxxxx xx xxxxxxxxx xxxxxxx to xxxxxxx xx criminal xxxx stipulates x xxxxxxxxxx xxxx xx 1 xxxx from xxx date xx xxxxx xxx xxxxxx xxxxxxx xx the xxxx xxxxxx xx xxx xxxxx. If xxxx date xxxx xxx xxxxxxxx xxxx xxx date xx xxx commitment of xxx xxxxx, xxx xxxxxx shall xxxxxxx xxxxxxxx xx xxx xxxx xx xxxxx xx/xxx xxxxxxx of xxx xxxxxxxxxxxx. Xxx Xxxxxxxx xx Xxxxxxx xxxxxx meet an xxxxxxxxxxx xxx xxx xxxxxxxxx of xxxxxxxxx xxxxxxx received anytime xxxxx xxx lapse xx xxx xxxxxxxxxxxxxx xxxxxx.

- Xxxxxxxxx xxxxxxx xx xxxxxxx xxx xx x xxxxxx xxx xxx xxxxxxxx xxxxxx xxxx as x result xx xxx commitment of x crime may xx xx the xxxx of x xxxx sum xxxxxxxxx xx XXX 25,000 xx xx xxxxxx xxxxx xx xxxx xxxxxx xx the xxxxx xx xxxxxxx xxxxxxxxx xx xxxxxx xx xxx xxxxxx, xxxxxxx xx xxx xxxxxx xxxxxxxxxx xxxx xx xxx victim xx xxxxxxxxxxxx for xxx harm xxxxxxxx. Xxx total xxxxxx xx such support xxxx not xxxxxx XXX 150,000. If, xxxxx the xxxxxxxxx xx xxxxxxx, xxx xxxxxx xxxxxx xxxx xxx xxxx xxxxxxxx xxxxxxx xxx xxxxxx xxxxxxxx, xxx xxxxxx xxx receive xxxxxxxxxx xxxxxxx xx to xxx xxxxxx xx XXX 150,000 xx xx/xxx xxxxxxx xxx xx within xxx xxxxxxxxxxxxxx period of xxxx (i.e., 1 xxxx xxxx xxx xxxx xx which xxx xxxxxx xxxxxxx xx xxx xxxx xxxxxx xx xxx xxxxx); xx xxxx xxxx, xxx xxxxxxx xxxxxxx xxxx xxxx xx xxxxx xxxx xxxxxxx.

- An individual xxx xx x xxxxxxxx of x xxxxxx xxx xxx xxxx as x xxxxxx xx xxx xxxxxxxxxx xx a xxxxx (x xxxxxx, xxxxxx xx xxxxx xx xxx deceased xxxxxx in x xxxxxx xxxxxxxxx xxxx xxx xxxxxxxx xx xxx time of xxx/xxx xxxxx or xxxxxxxxx xx or xxxxxxxx xx xx xxxxxxxxx xx xxx xxxxxxxx) xxxxx be xxxxxxxx xxxx a xxxx xxx amounting xx XXX 150,000. Xxx xxxxx xxxxxx xxxxxxxx xx xxxxxxxxx xxxxxxx shall xxx xxxxxx XXX 450,000; xxxxxx xxx xxxxxx xx victims exceed xxxxx, xxx xxxxxx xxxxxxxx xxx victim xxxxx xx xxxxxxx xxxxxxxxxxx.

- Act Xx. 209/1997 Coll. xxxx xxx xxxxxxx the xxxxxxxxx xx xxx xxxxxxxxx liability of xxxxxxxxx xx xxxxx xxxxxxxx xxxxxxx xx xxxxxxxxxx liability insurance. Xx xxxxxxx xxxxxxx xx traffic xxxxxxxxx, xxxxxxxxxxxx xxx xxxxxxxxx xxxxxxxx xxxxxx xxxx xx directed to xxx xxxxxxxx xxxxxxxxx xxxx xxxxxxxxx xxxxxxxxx. Xxxx xx xxxxxxxx xxxxx, xx xxxx xx xxxxxxxxxxx xxxxxxxxxxxxx, xxx xx application xxx xxx provision xx financial xxxxxxx xx xxxxx xxxx xxx Xxxxxxxx of Xxxxxxx.

- Xxxxxx xxxx xx mind xxxx xxx xxxxxxxxx documents xxx confirmations required xxx the xxxxxxxxxx xxxxx must xx xxxxxxxx xx xxx xxxxxxxxxxx. Xx xxx xxxxxxxxx xxxxx to xx so, xxx Xxxxxxxx xx Justice xxxxxx xxxxxxxx process xxx application. Should xxx xxxxxxxxx fail xx deliver any xxxx xxxxxxxxx and xxxxxxxxxxxxx xxxx xxxxxx x xxxxxxxxxxxxx xxxxxxxx, xxxx fact may xxxxxxx x xxxxxxxx xx withhold xxx xxxxxxx xx per Xxx Xx. 209/1997 Xxxx. This xxxxx xxx, xxxxxxx, prejudice xxx xxxxxx xx xxxxxxx application.

- Xxxxxx xxxx xx mind xxxx the applicant xxxxx be xxxxxxx xx xxxxxx xxx xxxxxxxxx amount xxxxxxxx xx xxxxxxxxxxxx xxx xxxx (xxxx xxx xxxxxxxx, xxxxxxxx etc.) xx xxx xxxxxxx xx xxx Xxxxxxxx xx Xxxxxxx up xx the xxxxxx xx the xxxxxxx xxxxxxxx. This obligation xxxx xxx apply xx xx/xxx has xxx xxxxxxxx xxx xxxxxxxxxxxx. Xx so xxxxxxxxx xx xxx xxxxxx xx an xxxxxxxxxxx, xxx Xxxxxxxx xx Justice xxx xxxxx xxx state's xxxxx xx claim xxx xxxxxx of xxx xxxxxxxxx xxxxxxx xxxxxxxx after xxx xxxxx xx the xxxx-xxxx xxxx, provided xxxx x xxxxxx xx justified xx xxx victim's xxxxxx xxxxxxxx, xxx xxxxx xxxxxx of xxx xxxx suffered xxx xxx xxxxxx of xxxxxxxxxxxx xxxx to xxx xxxxxx.

Xxxxxx xxx/xxxx/xxxxxx

Xxxxxxxxxxxxxxx xx, xx x xxxxxxxx, v ktorej xx xxxxxxxxxx, sme xxxxxx Vás xxxxxxxxx xxxxxxxxxxxx xxxxxxxx. V xxxxxx xxxxxxxx xxxxxxxxx Xxxxx žiadosti x xxxxxxxxxxx peňažnej pomoci xxxxxxx trestnej xxxxxxxx xxxľx zákona č. 209/1997 Zb., xx však vyplnenie xxxxx xxxxxxxxx nevyhnutné. Xxxxxxxx Xxx xx xxxxxxxxxx, xxxxx si xxxxx xxxxxx.

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X. Xxxxxx, xxxxxxx čitateľne xxxxxx xxxxx o xxxxxxxľxxx - xxxxx trestného xxxx, xxxxxx spôsobili xxxx xx xxxxxx, xxxxx xxxxx xxxxxxxxxx xx xxxxx, ktorá x xôxxxxxx xxxxxxxxx xxxx zomrela:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx xxxxxxxxx:

4. Xxxxxx xxxxxxxx xxxxxx:

5. Xxxxxxxxxxxxxx xxxxxx (x xxxxxxx, že sa xxxx xx xxxxxx xxxxxxxx bydliska):

6. Telefón:

7. X-Xxxx:

8. Xxxxxxxxxx:

XX. Ak xxxxxxxľx zastupuje xxx xxxxx (zástupca) xx xxxxxxx zákonného xxxxxxxxxx (xxxx. xxxxxxxx xxxxx xxxxxx xxxxxxx) xxxxx xx xxxxxxx dohody x plnej xxxx, xxxxxxx xxxxx o xxxxxxxxxx:

1. Xxxxxxxxxx:

2. Meno:

3. Xxxxxxxxxxxxxx xxxxxx:

Xx xxxxxxx xx xxx osobu, xxxx sa xxxxxxx xxxxxxxxxx, xxxxx xxxxxxxxxx xxxxxxx. Preto k xxxxxxxx xxxxxxxx xxxxx xxxxx xxxx (xxx xxxxxxxx zastúpení) xxxxx xxxxx xxxxxxx xxxxx (x xxxxxxx xxxxxxxxx xxxxxxxxxx) xxxxx inú xxxxxxx listinu.

III. Xx xxxxxxxľ alebo osoba xxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xxxxxxx, prosím, xx xxxxx x umretej xxxxx:

1. Xxxxxxxxxx:

2. Xxxx:

3. Xxxxx narodenia:

4. Xxxxx xxxxxx:

5. Xxxxxxxx bydlisko:

7. Xxxxxxxxxx:

8. X akom xxxxxx bola xxxxxxx xxxxx x xôxxxxxx xxxxxxxxx xxxx x xxxxx xxxxxxxľx (xxxx, xxxxx, xxxxx žijúca x spoločnej xxxxxxxxxx):

Xx xx xxxxxxxľ xxxxxx xxxxxxxxxx xx xxxxx, xxxxx v xôxxxxxx xxxxxxxxx činu zomrela, x xxxxxxxx sa xxxx xxxxxxxx kópia xxxxxxxx listu x xxxxxxx, ktoré xxxxxxxxx xxxxxxxxxx, že xxxxxx xxxxx xxxxxxxxxx xxxxxxxxx xxxxx xxxxx mala xxxxxxxxx ju xxxxxxxxx (xx xxxxxx rodič - xxxxx pôjde x rodný xxxx xxxxx xxxxxxxxxxx xxxx x xxxxxxxxxxx xxxxxxxxxx, xxx xxxxxxxx xxxxx xxxxxxxx xxxx sobášny xxxx x xxx.)

XX. Xxxxxx, xx xxxxxxx xxxxxxxx peňažnú xxxxx xxxxxxxxxxxxxxx pošty xxxxx xxxxxxxx xx xxxxxxx xxxx; x xxxxx xxxxxxx xxxxxxx xxxxxxx xxxxx Xxxxx xxxx.

X. Xxxxxx xxxxx, xxxx xx xxxx xxxxxxxxx x xxxxx spôsobenej xxxxxxxx xxxxx.

Xxxxxx xxxxx xxxxxxxxx xxxxxxxxx xxxx x xx sa xxxx x xxxxx xxx xxôxxxxxxx xxxxxxxxx xx xxxxôx, uveďte xxxx x ako (xxxxxxxxx x lekárskej xxxxxx - xxxxx xxx xxxxxxxxxx).

XX. Xxxxxxx xxxxx xxxxx x xxxxxxxx xxxxxx (xxxxxxxxx xxxxx, štátne zastupitelstvo, xxx), xxxxx xxxxxxxxx xxxxx konanie x xxxxxxxx xxxx. Uveďte xx xxxxxxx xxxxxx, xxx ktorou xxxxxxxx xxxxxxxxxxxx.

Xx xxxx k xxxxxxxxxx xxxxxxxx xxxxxxxxxxx xxxxxx činného x xxxxxxxx xxxxxx, ktoré xxxx xxxxxxxxx x xxx, v xxxx xxxxxx xx vec xxxxxxxx (xxxx. xxxxxxxxx x odložení xxxxxxxxx xxxxxxxx, xxxx obžaloby, xxxxxxxx - x xxxxxxxxxxxxx), xxxxxxxx ho x xxxxxxxx.

XXX. Uveďte, xxxx xxôxxxxx ste xxxxxxxxx xxxxx xx xxxxxxx xxxxx xx xxxxxxxľx alebo xxxx xxxxx, ktorá xxxxxxxxx xx xxxxx.

Xxxľx xxxxxxxxxxx §8 xxxxxx x. 209/1997 (Xx)., peňažitá xxxxx sa xôxx xxxxxx alebo sa xxxxxxxx x prihliadnutím xx xx, xx xxxx xxxxxxx xxxxxx xxxxxxx xxxxxxxxxxx xx xxxxxxxxxx xxxxxx xx xxxxxxx xxxxx od xxxxxxxľx xxxxx xxxx xxxxx, xxxxx xxxxxxxxx xx xxxxx. Xxxxx xxx nevyplňujte, ak xxxxxxxľx xxxxxxxxx xxxx xxxxxxxxx.

Xxx XXXX. Xxxxxxx, xx xxxxxxxľ xx xxxxxxxxxx xx xxxxx, xxxxx x dôsledku xxxxxxxxx xxxx xxxxxxx.

XXXX. Xxxxxx, či xxx xxxxxxx xxxxxx, ktorá xxľxx xxxxxxxxx xxxxxxx x §2 xxxx. 2 xxxxxx č. 209/1997 Xx., xxxxxxxx xxľxx xxôx xxľxx xxxxx xxxxxxxxx, xx xx Xxx tieto xxxxxxxxxxx xxxxx.

1. Boli xxx xxxxxxx, manželom xxxxx xxxxxxxx xxxxx, xxxxx zomrela x xôxxxxxx xxxxxxxxx xxxx?

2. Xxxx xxx s xxxxxx xxxxxxxxx xxxx xxxx xxxxxxxxx trestného xxxx x xxxxxxxxx xxxxxxxxxx?

3. Xxxxxxxxxxx Vám xxxx trestného činu xxxxxx, xx bola x xxxx xxxxxxx?

4. Xxľxxxx xxxxx osoby xxxxxxxxxxx podmienky 1 xx 3? Xxxxxx xxx počet, ak Xxx xx xxxxx.

Xxxľx xxxxxxxxxxx §2 xxxx. 2 xxxxxx č. 209/1997 Xx. xx xx xxxx považuje xxxxx xxxxxxxxx xx xxxxx, ktorá x xôxxxxxx xxxxxxxxx xxxx xxxxxxx, xx je xxxxxxx, manželom alebo xxxxxxxx zomretého x xxxxxxx v xxxx xxxx xxxxx x xxx xxxx v xxxxxxxxxx xxxxx xxxxx, xxxxxx nebohý xxxxxxxxxx xxxxx xxx povinný xxxxxxxxxx xxxxxx.

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Xxxx XX. xx XIV. Xxxxxxx, xx xx xxxxxxxľ xxxx xxxxxx xxxxxxxxx xxxx x bola xx xxôxxxxxx xxxx xx xxxxxx.

XX. Xxxxxx xxxxx, xxxx xx xxxxxxxx xxxxxxxx, respektíve xxxx xx xxxxxxxx xxxxxxxx xxxxxxxxxxx.

X. Celková xxxxx xxxxxxxx xxxxxxxxxxx xx bolesť činí:

K xxxxxxxx xx musí xxxxxxxx xxxxxx xxxxxxxxxxx xx bolesť podľa xxxxxxxx č. 440/2001 Zb., xxxxx xxxxxxxľ získa xx xxxxxx, xxxxx xx xxxxxxxxx. Xxxxx xxxxxxxx xxxxxxx xxxx xxxxxxxxx xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxxx x xxxxxx xxxxxxxxxx xxxxxxxx xxxxxxxxxxxxx xxxxxxxxxx. Xxxxxxxxxxx, xx xxx účely xxxxxx č. 209/1997 Zb. xx xxxxxxxxxx xxx xxxxxx xxxxxxxxxxx xxxxxxxxx xxxxxxx. Podľa xxxxxxxxxxx §6 xxxx. 2 zákona x. 209/1997 Zb. nemožno xxxxxxxxx' xxxxxxx xxxxx, xx bodové xxxxxxxxxxx xxxxxxxxx xxxxxxx nedosiahne xxxxxxxx 100 xxxxx.

XX. Xxxxxx, xx žiadate x poskytnutie peňažnej xxxxxx xx xxxxx xxxxxxxxx xxxxxxx 25 000.- Xx xxxxx xx xxxxxxxx xxxxx xxxxxx xxxxxxx x nákladov xx xxxxxxxx.

Xxxľx ustanovenia §7 odst. 1 xxxx. x) xxxxxx x. 209/1997 Xx. xx xxxxxxx obete xxxxx xxxxxxxxx xxxxxxx xxxxx xx xxxxx xxxxxxxxx xxxx 25&xxxx;000.- Xx, alebo vo xxxxx xxxxxxxxxxxxxx xxxxxxxxxxx xxxxxxxx xx liečenie x xxxxxx xxxxxxx. Xx xx xxxxxxxxxx xxxxxx x xxxxxxx xxxxx vo xxxxx xxxxxxxxx xxxxxxx, nemusíte xx xxxxxxxxx body XXX. - XXX. xxxxx xxxxxxxxx.

XXX. Xxxxxxx xxxxxxx x liečením xxxxxx:

Xxx o náklady xx lieky, zdravotnícke xxxôxxx, náklady na xxxxxxxxxxxxx, xxxxxxxxx xxxxxx xxxxx na xxxxx x xxxxxxxxxx xx xxxxxxxxxx, zvýšené xxxxxxx xx dopravu, x xxx. xxx podmienkou, xx xxxxx náklady xxxxxxxxx xxxxxxxxx. Tu xxxxxxx xxxxxxx xx xxxxx xxxxxxx, xxxx xx xx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxx xxxx xxxx xxxxxľ.

XXXX. Popište xxxxxxxxx xxxxxx xxxxxxxľx xxxx a xx xxxxxx xxxx xx xxxxxx spôsobenej xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxx, ktoré xxxxxxxxxx xxxxxxx skutočnosti.

V xxxxxxx, xx žiadateľ xx x xxxxxxxxxxxxxx pomere, xôxxx x xxxxxxxxxx xxxxxxxxxxxxľx o priemernom xxxxxxx xxxľx §351 x xxxx. zákona x. 262/2006 Zb., xxxxxxxx xxxxx, x xxxxx neskorších predpisov. Xx je xxxxxxxľ xxxxxx xxxxxxxxxx xxxxxxxxx xxxxxx, xxxxx xxxxxxxx xxxx xxxxxxxxx opis xxxxxxxxxx daňového xxxxxxxxx. Xx xxxxxxxľ poberá xxxxxxxx xôxxxxxx, xxxxxxxx, xxxxx xôxx xxxxxxx xxxxxxxx sociálnu xxxxxxxx, xxxx potvrdenie x xxxxx xxxxxxxxxx xôxxxxxx. X prípade, xx x nejakého xxxxxxxxx xôxxxx nemožno doložiť xxxxxxxxx xxxxxx xxxxxxxľx, x xxxxxxx xxxxxxx xx xxxxx xxxxxxxx xxxxxxxxxx x xxxx xxxxxxx xxxxxxxxxx.

XXX. Xxxxxx xxxxx xxxxxxxxxxxx xxxxx (xxxxxxxxxxx xôxxxxxx) x xxxx, xxxxxx xxx xxxxxxxľ xxxxxx, xx xxxxxxx xx vzniku xxxx xx zdraví, xxôxxxxxxx xxxxxxxx xxxxx.

X xxxxxxxx xxxxxxxx xxxxxxxxxx xxxxxxxxxxxxľx xxxxx xxxxxxxxx x xxxxx xxxxxxxxxxxx xxxxx. X xxxxxxx, xx x dôsledku xxxxx xx xxxxxx xxôxxxxxxx xxxxxxxx xxxxx Xxx xxxxxxxx xxxxxxxxx xôxxxxxx, uveďte x xxxxxxx xxxx xxxxx.

Xxxx majetkové xxxxxx xx také, že xxxxxxxx xxxxx, xxxxxxx xxx xxx(x) obeťou, xx xxxx sociálna xxxxxxxx zhoršila. Xxxxx, xxxxx xx xxxxx xxôxxxxx, xxxxxľ xxxxxx xxxxxxxx.

Xxxxxx xxxxxxxxxx, že xxxxx xx xxxxxxx xxxxx či xxxxxxx xxxxx na odškodnenie xxxx xxôxxxxxxx xxxxxxxx xxxxx som xxxxxxxxxx(x) x xxxxxxx inom xxxxx ako v Xxxxxx (Slovenskej) republike.

Beriem xx xxxxxxx, xx xx xxxľx xxx. §12 xxxxxx x. 209/1997 Xx., x xxxxxxxxxx xxxxxxxx xxxxxx xxxxxxx xxxxxxxx xxxxxxxx x x xxxxx x x xxxxxxxx xxxxxxxxxx xxxxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx, xxxxxx povinnosť xx xxxxxxx xxxxx odo xxx, xxx xx xxxxxxxx pomoc, xxxxxxx xx účet Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxxxxx, xxxxx xxx dostal(a) xxx xxxxxxx xxxxx, x xx xx do xxxxx xxxxxxxxxxx xxxxxx. Xxxxxxx x tým xxxxxx na xxxxxxx, xx xx xxxxxxxx xxxxxxxxxx päťročnej xxxx xôxxx požiadať Ministerstvo xxxxxxxxxxxxxx, aby xx x xxxx xxxxx xxxxxx xxxxx na xxxxxxxx xxxxxxxxxxx xxxxxx, xx xxxx sociálna xxxxxxxx xxxx xxxx xxxxxx xxôxxxxxxxx, xxxxxxx xxxxx škody, xxxxx xx xxôxxxxxx x xxxxx xxxxxxx, ktorú xxx xxxxxx(x).

Xxxxxx tiež xx vedomie, xx xxxxxxxxx uvedením xxxxxxxxxxx xxxxx xxxxxxxxx xxxxx xx jeho xxxxxxxxx xx xxxxxx získania xxxxxxxxxxxx xxxxxx, sa xôxxx dopustiť xxxxxxxxxx xxxľx §21 odst. 1 písm. x) xxxxxx x. 200/1990 Xx., o xxxxxxxxxxxx, x xxxxx xxxxxxxxxx xxxxxxxxx.

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xxxxxx xxxxxxxľx xxxxx xxxxxxxx

- Xxxxxxxxxxxx spravodlivosti Xxxxx republiky xx xxxxxxx xxxxxxxx x xxxxxxxxxxx xxxxxxxx xxxxxx xxxľx zákona č. 209/1997 Zb. xxxxxxx xxx príjem x udelí xxxxxxxx xxxxx. Xxxxx xxxx xxxxxxxxxx na polícii xx xx xxxx xxxxxxxx xxxxxx xxxľx xxxxxxxxxxx okolností xxxxxxx. Xx xxxxx xxxxxxxx xx xxxxxx žiadosti x predložení xxxxxxxxxx xxxxxxxx xxx pomoc xxxxxxxx alebo xxxxxxxľxxx xxxxxx xôxxxx, xxxxx xxxxx xxxxxxx xxxxxxxx.

- X xxxxxx zákona č. 209/1997 Zb. xxxx xxxxxxxľ xxxxxxxxxx xx xxxx xxx x prípade, xx mu v xôxxxxxx trestného xxxx xxxx xxôxxxxxx xxxxxxxxxx xxxxxxx. Nevyhnutnou, nie xxxx xxxxxxxxxxxx xxxxxxxxxx xx priznanie xxxxxxxx xxxxxx xxxxx obeti xx xxxxx bodového xxxxxxxxxxx bolesti (nie xxxx sťaženie spoločenského xxxxxxxxxx) xxxxxxxxxxxx aspoň 100 xxxxx. Xx xxxx xx xxxxxxxx xx xxxxx xxxxxxxxx xx xxxxx, ktorá x xôxxxxxx trestného xxxx xxxxxxx, xx xxxx rodičom, xxxxxxxx xxxxx xxxxxxxx xxxxxxxxx x zároveň v xxxx xxxx xxxxx x ním xxxx x domácnosti, xxxxx xxxxx, ktorej zomretý xxxxxxxxxx xxxxx xxx xxxxxxx xxxxxxxxxx xxxxxx.

- Xxxxx č. 209/1997 Zb. o xxxxxxxxxx xxxxxxxxx xxxxxx xxxxxxx xxxxxxxx činnosti xxxxxxxxx xxxxxxxxxxx (prepadnú) xxxx 1 xxxx xxx dňa, xxx xx xxxx dozvedela x xxxxx spôsobenej xxxxxxxx xxxxx. Ak xxxxx xxxx xx xxx je xxx xxxxxxxxx trestného činu, xxxx xxxxxxxx xxxxxxx, xxxx xx to xxxxx. Xxxxxxxxxxxx xxxxxxxxxxxxxx xxxôxx vyhovieť xxxxxxxxxx x poskytnutie peňažnej xxxxxx, xxxxx xx xxxxxxxx xx xxxxxxxx xxxxxxxxxx lehoty.

- Xxxxx xx na žiadosť xxxxx, xxxxxx v xôxxxxxx trestného xxxx xxxxxxx škoda xx xxxxxx, xxxxxxxx x xxxxxxxxx xxxx 25&xxxx;000.- Xx alebo xx xxxxx, ktorá xxxxxxxxxxx xxxxxxxxxx xxxxxx na xxxxxxx, preukázané xxxxxxx xxxxxxx s xxxxxxxx, xxxxxxx x xxxxx xxxxxxxx xxxxxxx, ktoré xxxx x xxxxxx xxxxxxx xxxxx už xxxxxxx; pomoc xx xxxxxx súčte xxxxxx xxxxxxxxxx sumu 150 000.- Xx. Xx xxxx - xx tom, xxx jej xxxxxxxx xxxxx - preukáže, xx xxx vzniknutá xxxxx je xxxxxx xxx xx, xxxxx xxxx xxxxxxxxx xx xxxxxxxxxxx xxxxxx, na xxx xxxxxxx v xxxxxx xxxxxxxxxx týmto xxxxxxx jej možno xxxxxxxxx pomoc opäť, x xx xx xx xxxxxxxxxx xxxxx 150&xxxx;000.- Xx; xxxxxx xx xxxxxxxxxx na xxxxxxx, xxxxx xx xxxx xxxxxxxxx.

- Xxxxxxxx xxxxx, xxxxx je xxxxxxxxxx po xxxxx, xxxxx x xôxxxxxx xxxxxxxxx xxxx xxxxxxx (xx xxxx xxxxxxx, xxxxxxxx xxxxx dieťaťom xxxxxxxxx x xxxxxxx x xxxx jeho xxxxx x xxx xxxx x xxxxxxxxxx, xxxxx jej xxxxxxx xxxxxxxxxx, xx xxx xxxxxxx poskytovať výživu), xx xxxxxxxx xxxxxxx xxxxx v paušálnej xxxx 150&xxxx;000.- Xx; xxxxx xx xxxxxx xxxxx nesmie presiahnuť xxxx 450 000.- Kč, x xx je xxxxx xxxxx viac xxx xxx xxxxx, xxxxxxxxxxx čiastka xx xxx xxxxxx obeti xxxxxxxxx kráti.

- Xxxxx č. 209/1997 Zb. nenahradzuje xxxxxxxx xxxxxxxxxxx zodpovednosti xxxxxxxxxxľx xxxxxxxxxx xxxxxxxx, xx xxxxx nadväzuje povinné xxxxxxx poistenie xxxxxxxxxxxxx. Xxxxx xx potrebné x záležitostiach xxxxxxxxxx xxxôx xxxxxx subjekt, xxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxxxxx, x poskytnutie xxxxxxxxx plnenia. Len x celkom xxxxxxxxxxx xxxxxxxxx x xxxxxxxxxxxxx xx xxxxxxxxx xxxxxxxxx xxxxxxxxx je xxxxx xxxxxx ministerstvo spravodlivosti x poskytnutie xxxxxxxx xxxxxx.

- Xxxxxxxxxxx, xx xx nevyhnutné xxxxxxxx xxxxxx xxxxxxxx doklady x potvrdenia, xx xxxxx xxxxxxxxxx xxx xxxxxxxxxxxx xxxxxxxxx. Ak xxx žiadateľ xxxxxxx, xxxxxxxxxxxx spravodlivosti xxxôxx xxxxxxx xxxxxxx. Ak xxxxxx xxxxxxxxxx x xxxxxxx xxx dodatočne xxxxxx, táto xxxxxxxxxx xôxx xxx xôxxxxx xxxxxxxxxxxxx xxxxxxxx xxxxxx xxxľx xxxxxx č. 209/1997 Zb. Xx xxxx xxxxxxxxxx xxxxxxx xxxxx xxxx xxxxxxx.

- Xxxxxxxxxxxx, xx xx xxxx xxxxxxxľxxx xxxxxxxxxx xxxxxxx pomoc, xxxxxxxľ xx xx xxxxxxx rokov xxx xxx xxxxxxxxxxx xxxxxx xxxxxxx xx xxxx xxxxxxxxxxxx xxxxxxxxxxxxxx xxxx, xxxxx dostal ako xxxxxxx xxxxx (xx xxxxxxxľx, poisťovne x xxx.) xx xx xxxxx poskytnutej xxxxxx. Xxxx povinnosť nemá, xx xx xxxxx xxxxxxxxxx. Na xxxxxxx xxxxxxxx xxxxx xx xxxxxxxxxxxx xxxxxxxxxxxxxx môže x xxxx štátu xx xxxxxxxx xxxxxxxxxx xäxxxxxxx xxxx vzdať xxxxx xx xxxxxxxx xxxxxxxxxxx xxxxxxxx pomoci. Xx xxxxxx postup xxôxxxxxxx sociálna xxxxxxxx xxxxx, xxxxxxx xxxxx xxxxx, ktorú xxx xxôxxxxxx, x výška xxxxxxx, ktorú obeť xxxxxxx.